of combination interferon-based therapy for chronic
hepatitis C usually focus on adults, who typically demonstrate
sustained virological response
(SVR) rates of just under 50% for HCV
genotype 1 and 70%-80% for genotypes
2 or 3 using a standard regimen of pegylated
interferon plus ribavirin for 48 or 24 weeks, respectively.
Treatment of children with hepatitis C has not been as extensively
In the present study, Etienne Sokal from Catholic University
Louvain in Belgium and an international team of colleagues evaluated
the safety and efficacy of pegylated
interferon alfa-2a (Pegasys) plus ribavirin in previously
untreated HCV antibody positive children with detectable HCV
RNA viral load.
This prospective analysis included 18 children with HCV genotypes
2 or 3, who were treated for 24 weeks, and 47 children with
harder-to-treat genotypes 1, 4, 5, or 6, who were treated for
of the genotype 2/3 children and 57% of the genotype 1/4/5/6
children achieved early virological response at week 12.
response rates were 94% (at week 24) and 57% (at week 48),
rates were low, with 89% of easier-to-treat participants
and 57% of hard-to-treat children achieving sustained response
at 24 weeks after completion of therapy.
participants overall (15%) stopped treatment prematurely
-- 2 due to serious adverse events and 8 due to lack of
virological response at week 24.
children overall (23%) had their pegylated interferon or
ribavirin doses adjusted -- 11 (17%) due to neutropenia
and 3 (5%) due to anemia.
most common treatment-related adverse events included:
and flu-like symptoms (54%);
depression, or mood changes (34%);
of appetite (22%).
treatment had no observed effect on the children's growth
results, the researchers concluded, show that children have
an improved rate of sustained virological response compared
with reference studies of adult chronic C patients treated with
Investigator affiliations: Université Catholique de
Louvain, Cliniques universitaires St Luc, Bruxelles, Belgium;
Paediatric Gastroenterology, Hospital de clinicas de Porto Alegre,
Porto Alegre, Brazil; Unidade de Hepatologica Pediatrica, Hospital
das clinicas da faculdade de medicina da universidade de Sao
Paulo, Sao Paulo, Brazil; Department of Pediatrics, Stradin
University, Riga, Latvia; Department of Paediatrics, CLINTEC,
Karolinska University Hospital, Huddinge, Stockholm, Sweden;
Liver Unit, Birmingham Children's Hospital, Birmingham, UK.
Sokal, A Bourgois, X Stéphenne, and others. Peginterferon
alfa-2a plus ribavirin for chronic hepatitis C virus infection
in children and adolescents. Journal of Hepatology 52(6):